Correlation between changes of platelet-related parameter and prognosis of septic patients / 中华急诊医学杂志

ABSTRACT

Objective To investigate the correlation between platelet-related parameters and the severity as well as prognosis of septic patients.Methods A total of 91 patients with sepsis were included in this study, and the platelet-related parameters were detected in all patients within 24 hours and 72 hours after admission to hospital, respectively.Clinical information of each patient was recorded including age, gender and underlying diseases, APACHE Ⅱ score at admission and the incidence of the consequent multiple organ dysfunction syndrome (MODS) and 28-day mortality.The differences in platelet-related parameters between non-severe sepsis group and severe sepsis group were compared, the correlation between plateletrelated parameters and the prognosis was studied by using rank method and the reliability of platelet-related parameters to predict the prognosis was estimated by using receiver operating characteristic curve (ROC).Results The differences in results of platelet-related parameters between non-severe sepsis group and severe sepsis group within 24 hours and 72 hours after admission were as follows platelet count (166.34 ± 58.27) ×109L-1vs.(198.57±65.82) ×109L-1, P=0.02and (138.85 ± 53.31) ×109L-1vs.(173.79 ± 67.48) × 109 L-1, P =0.00;the platelet distribution width (PDW) (13.84 ± 2.46) ％ vs.(12.73±1.72)％, P=0.01 and (16.07 ±2.87)％ vs.(13.86 ±2.31)％, P=0.00;mean platelet volume (MPV) (10.17 ±1.82) fl (femto-liter) vs.(9.32 ±1.34) fl, P=0.01 and (11.49 ± 1.53)fl vs.(10.37 ± 1.24) fl, P =0.00, respectively.The value of the PDW showed positive correlation with the prognosis (dead) (r=0.51, P＜0.05), and the MPV did likewise (r=0.53, P＜0.05, while the platelet count negatively correlated (r =-0.61, P ＜ 0.05), These characteristics were more obvious at 72 hours after admission (rPDW =0.68, rPv =0.67, rPLT =-0.71, P ＜0.01).The areas under the ROC curve 72 hours after admission as follows PLT count0.95, PDW0.93 and MPV0.93, respectively, which were higher than those of PLT count (0.88), PDW (0.82) and MPV (0.83) within 24 hours after admission.The sensitivity and specificity of platelet count 72 hours after admission predicting the prognosis of death were 91.24％ and 80.35％, respectively.Conclusions The changes of platelet-related parameters in septic patients are related to the severity of the disease, and platelet count at 72 hours after admission may play an important role in prognosis of disease.